What Is It?
A neuroma in the foot is a noncancerous swelling along a nerve in the foot that carries sensations from the toes. The cause of this swelling is unknown. Once swelling begins, the nearby bones and ligaments put pressure on the nerve, causing more irritation and inflammation. This results in burning pain, numbness, tingling and other abnormal sensations in the toes.
A neuroma typically develops between the third and fourth toes. Less commonly, it can develop between the second and third toes. Other locations are rare, but possible. It also is rare for a neuroma to develop in both feet simultaneously. The condition is much more common in women than men, possibly a result of wearing high-heeled, narrow-toed shoes. Being overweight also increases the risk of a neuroma.
A neuroma most commonly causes burning pain, numbness or tingling at the base of the third, fourth or second toes. Pain can also spread from the ball of the foot to the tips of the toes. In some cases, there also is the sensation of a lump, a fold of sock or a “hot pebble” between the toes.
The pain of a neuroma is typically relieved temporarily by taking off your shoes, flexing your toes and rubbing your feet. Symptoms may be aggravated by standing for prolonged periods or by wearing high heels or shoes with a narrow toe area.
Your doctor may begin by asking questions about your shoes. To rule out other causes of pain, your doctor may also ask questions about your medical history, especially arthritis, nerve and muscle problems or previous injury to your foot or leg.
To confirm the diagnosis, your doctor will examine your feet to look for areas of tenderness, swelling, calluses, numbness, muscle weakness or limited motion. To check for a neuroma, your doctor will squeeze the sides of your foot, which should trigger your typical pain.
Based on the examination, your doctor usually can diagnose a neuroma without additional testing. A foot X-ray may be needed to ensure there isn’t a stress fracture present, but it will not show the actual neuroma. If the diagnosis is in doubt, your doctor may request magnetic resonance imaging (MRI) of the foot to confirm.
Typically, symptoms will come and go, depending on the type of shoes you wear and how much time you spend on your feet. Sometimes, the symptoms will go away completely.
It is not always possible to prevent a neuroma. You can reduce your risk by wearing comfortable shoes that have low heels, plenty of toe space and good arch support.
If your neuroma is painful, your doctor usually will begin treatment with therapies including:.
- Switching to shoes with low heels, wide toes and good arch support
- Using metatarsal pads or toe crest pads
- Using shoe inserts to help correct any mechanical imbalance in the foot
- Anti-inflammatory medication
- A local injection of anesthetic and corticosteroid medication
More than 80 percent of people with a neuroma will respond to conservative treatment. For people who have persistent, disabling symptoms, surgery may be an option.